Self Harm Awareness NSSI nonsuicidal self injury. By Becky Perry.
- smonceauxconsultin
- Mar 7
- 5 min read
Social workers, counselors, psychiatrists, teachers, parents and pastors are working together to understand and create viable options for those who deliberately harm themselves. As conversations have become more open and stigma has decreased, a growing number of individuals are acknowledging how self-harm has touched their lives—at home, school, work, or church.
This blog will focus on myths pertaining to cutting, possible ways to inflict pain and reasons for self-harm, psychological implications on the cutter’s mind, what the caregiver can look for as well as the emotional toll on caregivers, and how to effectively communicate when a person may be struggling.
Self-harm also known as nonsuicidal self-injury (NSSI), is defined as the deliberate, self-inflicted destruction of body tissue without suicidal intent. It is a behavior that individuals engage in to cope with emotional pain, stress, or overwhelming feelings.
**What are some myths about self-harm?
*Myth: Self-injury is about suicide: Reality: Self-injury is used most often as a survival technique than an exit strategy involving suicide. The myth is that a cutter wants to die by suicide when in reality they want to cope with overwhelming emotions.
*Myth: Self-injury encompasses a certain population. Reality: Age, gender, personality types, socioeconomic status are all included populations for self-injury.
*Myth: People who self-harm are seeking attention. Reality: Many people hide their injuries and feel shame about their actions. It is not about ‘seeking attention’ but is about ‘needing attention.’
*Myth: They will grow out of it. Reality: Self-harm is a coping mechanism that won’t disappear unless healthier alternatives are introduced.
In general, some individuals may stop self-harming in a short amount of time when resolving specific issues while others may suffer with long-term cutting strategies as their coping mechanism.
NSSI behaviors not only reference cutting, but involve a multitude of behaviors including, but not limited to:
Ingesting objects , inserting objects, using hot objects, impact with objects to include punching walls or other objects, impact with self, carving words or symbols into the skin, rubbing sharp objects into the skin, scratching or pinching, hair pulling (trichotillomania) smashing digits with hard objects, interference with wound healing, interfering with breathing (e.g. choking or asphyxiation), falling down stairs and allowing others, including animals to inflict physical pain.
Most tools reported for self-harm include using pens, scissors, kitchen knives, razor blades (small pencil sharpener blade), heated items (fire, curling irons, matches, lighters), glass, rocks, etc.
The ‘why’ someone would harm themselves varies depending on the level of emotional state and trauma-based pain. We all have experienced feelings that overwhelm us. Everyone has fears, shame, anger, frustration, sadness and at times feel hopeless. We may find various ways to face and cope with life stressors. It may be working out at the gym excessively, gambling, seek relief from food, drugs, drinks, works overtime to shop or cuts his/her own skin.
Many people who self-harm ‘use pain to erase pain’ making this thought process confusing for caregivers. Self-harmers want to be the ones to decide when and how they get hurt. Some direct comments from self-harmers may be, “I need a way to ‘release pain’”, “I just wanted to feel something, anything”, “I feel so lost and alone”, “I had to quiet my racing thoughts”, “cutting or hurting myself makes my invisible pain visible”, “I need help.”
Let’s take a moment to look at the brain chemistry of a cutter’s mind. Some people live through awful childhood or adolescent experiences but grow up to lead emotionally stable lives. On the other hand, others come from ‘normal’ and ‘happy’ homes but still struggle with psychological difficulties. In studying brain chemistry, self-harm behaviors can be linked to decreased serotonin activity, temporal lobe dysfunction, excessive levels of the neurotransmitter dopamine, and poor executive functioning. Too much dopamine in the brain makes clear and rational thinking more difficult. Decreased serotonin levels often cause depression, and temporal lobe malfunctioning leads to a multitude of issues, such as learning difficulties, problems with memory, language retrieval, and development of social skills. In addition, genetics may play a role in chemical imbalances. If the self-harmer with poor executive functioning in the brain does not keep to a ‘normal’ track because of genetic factors or if it is delayed due to severe trauma such as abuse, the self-injurer may experience aggressive mood swings, attention problems, suicidal ideation, obsessive preoccupation, impulsive risk taking and compulsive behaviors.
What should caregivers look for and how can they help their loved one? Learning to read signals and a watchful eye may help with initially identifying someone who is self-harming. Does your loved one have frequent cuts, burns or bruises that are typically explained away? Look for clothing that may seem unusual to wear such as long sleeves and pants in the summer, refusal to wear shorts or bathing suits, etc. Does the person seem to have a strong body dissatisfaction? Is there resistance to seeing a doctor for a seemingly innocent issue? Other behaviors out of the person’s norm such as withdrawing from family and friends, dramatic mood swings in a short time frame, continuous self-put downs, outbursts of anger, tears or extreme emotions. Have you found bandages (band-aids, gauge, etc) or common tools (razors, knives, etc) missing from the home?
The emotional toll on caregivers can lead to high stress levels. Remember to practice self-care for yourself to prevent burnout, frustration and emotional fatigue. It is important to role model by talking to a trusted friend/family member along with searching out your own therapist for help. It is essential that the whole family stay informed and united during life difficulties to support one another effectively.
Encourage open communication without shame using a nonjudgmental approach. Ideas may include listening more than you speak, being mindful of your reactions using a calm stance, normalizing talking about mental health expressing the thought they are not alone and this is not something to hide.
Conversations with your loved one is key to better communication.
Asking creative and open-ended questions may be helpful. Some examples are listed below.
* “If your wounds could speak, what would they say?”
* “When do you notice the urge to self-harm?”
* “What feelings do you experience before and after self-harming?”
* “What could be an alternative plan to help in these hard moments?”
Suggestions to help your teen with coping skills may include some of the following ideas.
• Ice Cube Hold
• Sensory Box
• Aromatherapy
• Chewing Gum
• Soap Carving
• Clay Molding
• Worry Stones
• Elastic Bands
• Sensory Stimulation
• Drawing on Skin
• Scribble Art
• Mandala Drawing
• Art Therapy
• Photography
• Crafting
• Origami
• Mindful Breathing
• Mindfulness Meditation
• Nature Walks
• Bubbles
• Popping Bubble Wrap
• Watching a Movie
• Doing Puzzles
• Stargazing
• Interactive Apps
• Playing Music
• Journaling
• Positive Affirmation Jar
• Tearing Paper
• Reading a Book
• Learning a New Skill
• Practicing Gratitude
• Letter Writing
• Calling a Friend
• Volunteering
• Create a Playlist
• Pet Therapy
• Cooking/Baking
• Gardening
• Mindful Coloring
• Temporary Tattoos
• Try a New Hairstyle
• Exploring a New Place
• Bird Watching
In conclusion, supporting a loved one through self-harm prevention is a process which may require patience, understanding and compassion. With open communication, discussing healthy coping skills together and using resources, we can learn to navigate through the behaviors and emotions safely.
